The acute and late toxicity results of a randomized phase II dose-escalation trial in non-small cell lung cancer (PET-boost trial)
Authors
van Diessen, DJDe Ruysscher, D
Sonke, JJ
Damen, E
Sikorska, K
Reymen, B
van Elmpt, W
Westman, G
Fredberg, PG
Dieleman, E
Bjorkestrand, H
Faivre-Finn, Corinne
Belderbos, J
Affiliation
Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The NetherlandsIssue Date
2018
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: The PET-boost randomized phase II trial (NCT01024829) investigated dose-escalation to the entire primary tumour or redistributed to regions of high pre-treatment FDG-uptake in inoperable non-small cell lung cancer (NSCLC) patients. We present a toxicity analysis of the 107 patients randomized in the study. MATERIALS AND METHODS: Patients with stage II-III NSCLC were treated with an isotoxic integrated boost of ?72?Gy in 24 fractions, with/without chemotherapy and strict dose limits. Toxicity was scored until death according to the CTCAEv3.0. RESULTS: 77 (72%) patients were treated with concurrent chemoradiotherapy. Acute and late ?G3 occurred in 41% and 25%. For concurrent (C) and sequential or radiotherapy alone (S), the most common acute ?G3 toxicities were: dysphagia in 14.3% (C) and 3.3% (S), dyspnoea in 2.6% (C) and 6.7% (S), pneumonitis in 0% (C) and 6.7% (S), cardiac toxicity in 6.5% (C) and 3.3% (S). Seventeen patients died of which in 13 patients a possible relation to treatment could not be excluded. In 10 of these 13 patients progressive disease was scored. Fatal pulmonary haemorrhages and oesophageal fistulae were observed in 9 patients. CONCLUSION: Personalized dose-escalation in inoperable NSCLC patients results in higher acute and late toxicity compared to conventional chemoradiotherapy. The toxicity, however, was within the boundaries of the pre-defined stopping rules.Citation
van Diessen J, De Ruysscher D, Sonke J-J, Damen E, Sikorska K, Reymen B, et al. The acute and late toxicity results of a randomized phase II dose-escalation trial in non-small cell lung cancer (PET-boost trial). Radiotherapy and Oncology. 2018 Oct.Journal
Radiother OncolDOI
10.1016/j.radonc.2018.09.019PubMed ID
30327236Additional Links
https://dx.doi.org/10.1016/j.radonc.2018.09.019Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.radonc.2018.09.019
Scopus Count
Collections
Related articles
- A secondary analysis of FDG spatio-temporal consistency in the randomized phase II PET-boost trial in stage II-III NSCLC.
- Authors: La Fontaine M, Vogel W, van Diessen J, van Elmpt W, Reymen B, Persson G, Westman G, De Ruysscher D, Belderbos J, Sonke JJ
- Issue date: 2018 May
- An individualized radiation dose escalation trial in non-small cell lung cancer based on FDG-PET imaging.
- Authors: Wanet M, Delor A, Hanin FX, Ghaye B, Van Maanen A, Remouchamps V, Clermont C, Goossens S, Lee JA, Janssens G, Bol A, Geets X
- Issue date: 2017 Oct
- Dose painting by contours versus dose painting by numbers for stage II/III lung cancer: practical implications of using a broad or sharp brush.
- Authors: Meijer G, Steenhuijsen J, Bal M, De Jaeger K, Schuring D, Theuws J
- Issue date: 2011 Sep
- F-18-FDG-PET confined radiotherapy of locally advanced NSCLC with concomitant chemotherapy: results of the PET-PLAN pilot trial.
- Authors: Fleckenstein J, Hellwig D, Kremp S, Grgic A, Gröschel A, Kirsch CM, Nestle U, Rübe C
- Issue date: 2011 Nov 15
- Heterogeneous FDG-guided dose-escalation for locally advanced NSCLC (the NARLAL2 trial): Design and early dosimetric results of a randomized, multi-centre phase-III study.
- Authors: Møller DS, Nielsen TB, Brink C, Hoffmann L, Lutz CM, Drøgemüller Lund M, Hansen O, Schytte T, Khalil AA, Knap MM, Nyhus CH, Ottosson W, Sibolt P, Borissova S, Josipovic M, Persson G, Appelt AL
- Issue date: 2017 Aug